摘要
目的探讨经颈内静脉植入完全植入式静脉输液港(TIVAP)导管长度的影响因素,为规范化植入TIVAP提供参考。方法收集134例在超声引导下经颈内静脉穿刺植入TIVAP女性患者临床资料,分为右侧组和左侧组,中位年龄57(39~76)岁。准确记录左、右侧颈内静脉穿刺点至导管头端距离(L1、R1)和TIVAP港体至导管头端距离(L2、R2),分析患者身高、体重对TIVAP导管置入长度(L1、L2、R1、R2)的影响,根据患者身高预估导管近段距离,并与实测数据作对比。结果右侧、左侧颈内静脉一次穿刺成功率分别为100%(78/78)、98.2%(55/56)。L1值为(17.03±1.36)mm,L2值为(27.36±2.04)mm,R1值为(14.79±0.98)mm,R2值为(25.30±1.38)mm;身高与L1、L2、R1、R2值均呈相关性(r值分别为0.290、0.403、0.259、0.301,P值分别为<0.05、<0.01、<0.05、<0.01)。右侧组、左侧组导管置入长度(L1与R1、L2与R2)间差异有显著统计学意义(P<0.01);预估近段距离与实测距离对比,差异无统计学意义(P>0.05);体重与L1、L2、R1、R2均无明显相关性;患者身高、体重对比,差异无统计学意义(P>0.05)。结论TIVAP植入部位首选右侧颈内静脉,可根据患者身高预估导管置入深度,使手术更方便快捷,同时推荐在超声和DSA导引下进行。
Objective To investigate the influence factors of the inserted length of catheter in implantation of totally implantable venous access port(TIVAP)via internal jugular vein access,and to provide a reference for standardized implantation of TIVAP.Methods The clinical data of a total of 134 female patients who received ultrasound-guided implantation of TIVAP via internal jugular vein access were collected.The patients were divided into right-side group(n=78)and left-side group(n=56),the median age was 57 years(39-76 years).The distance from the puncture point at left or right internal jugular vein to the catheter tip(L1,R1)and the distance from the port body to the catheter tip(L2,R2)were accurately measured.The influence of patient’s height and weight on the inserted length of TIVAP catheter(i.e.L1,L2,R1,R2)was analyzed.Based on the patient’s height the proximal length of the catheter was estimated,and the estimated length was compared with the measured data.Results The technical success rates of single puncturing through the right and left internal jugular vein were 100%(78/78)and 98.2%(55/56)respectively.The L1 value was(17.03±1.36)cm,L2 value was(27.36±2.04)cm,R1 value was(14.79±0.98)cm,and R2 value was(25.30±1.38)cm.A parallel correlation existed between the patient’s height and L1(r=0.290,P<0.05),L2(r=0.403,P<0.01),R1(r=0.259,P<0.05)and R2(r=0.301,P<0.01).Statistically significant differences in the inserted length of catheter(L1 and R1 versus L2 and R2)existed between the right-side group and leftside group(P<0.01).There was no statistically significant difference between the estimated proximal length and the measured length(P>0.05).The patient’s weight bore no relationship to the values of L1,R1,L2 and R2.There were no statistically significant differences in patient’s height and weight between the two groups(P>0.05).Conclusion The preferred implantation site of TIVAP is right internal jugular vein as it can make the operative manipulation more convenient and fast.The inserted length of catheter can be estimated based on patient’s height.It is recommended that the practical way to perform TIVAP is under the guidance of ultrasound and DSA.
作者
孙尚龙
陈海波
钱一丹
孙志超
SUN Shanglong;CHEN Haibo;QIAN Yidan;SUN Zhichao(Department of Medical Imaging,First Affiliaied Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou,Zhejiang Province 310006,China)
出处
《介入放射学杂志》
CSCD
北大核心
2019年第12期1167-1170,共4页
Journal of Interventional Radiology
基金
浙江省自然科学基金(LGD19C040002)
浙江省中医药科学研究基金(2020ZBO91)
关键词
完全植入式静脉输液港
颈内静脉
导管长度
totally implantable venous access port
internal jugular vein
length of catheter
